Dealing with male menopause

We know a lot about menopause in women, but do men also go through similar changes as they age?

It is not uncommon that many ageing men report similar symptoms that women experience during menopause. In addition, such symptoms can be relieved by treating these men with male hormones.The condition is becoming more widely recognised and accepted by the medical community and referred to as "male menopause."

The condition of male menopause usually occurs as the production of male hormones (androgen or testosterone) decline in the ageing male. Some also call the condition "andropause" or "low testosterone".

Although testosterone levels vary greatly among men, but older men tend to have lower testosterone levels than do younger men. In general, testosterone levels gradually decline throughout adulthood; about 1% a year after age 30 on average. Therefore, by about age 70, the decrease in a man's testosterone level can be as much as 50%.

Unlike the more dramatic reproductive hormone plunge that occurs in women during menopause, sex hormone changes in men occur gradually over a period of many years. The effects tend to be subtle and might go unnoticed for years.

And along with the decline in testosterone, researchers reported that as many as 40% of men over 40 experience some symptoms.

Male menopausal symptoms vary individually and can cause several changes in many aspects. Physical changes may include increased body fat; reduced muscle bulk, strength and endurance; and decreased bone density. Swollen or tender breasts and loss of body hair are possible.

Rarely, some might experience hot flashes and have less energy. Sometimes low testosterone causes sleep disturbances, such as insomnia, or increased sleepiness.

Low testosterone might also contribute to emotional changes, such as a decrease in motivation or self-confidence that results in sad feelings or depression, or cause trouble concentrating or remembering things. Some also experience sexual problems such as decreased libido, or difficulty in attaining and sustaining erections. However, the relationship of these symptoms to decreased testosterone levels is still not clear.

If you suspect that you have a low testosterone level, consult your doctor for complete evaluation of possible causes and discuss available treatment options.

Testosterone replacement therapy is the primary means of treating men with declining levels of testosterone. Such treatment may help relieve bothersome symptoms for some men, but for others, however, particularly older men, the benefits are less clear. But just as with hormone replacement therapy in women, testosterone replacement therapy has potential risks and side effects such as an increased risk of prostate cancer or other health problems. Consult your doctor to see if the treatment is appropriate for you.

One can also decrease the impact of low testosterone by living a healthy lifestyle. Certain lifestyle changes may also help alleviate the symptoms and should be used in combination with medication. These include a healthy diet and an exercise programme.

Hormone changes are a natural part of ageing. Learn to live with it. Be honest and admit if you have such problems. Seek help from your doctor early for better treatment outcomes.

Assoc Prof Dittakarn Boriboonhirunsarn is a member of the Faculty of Medicine, Siriraj Hospital.

About the author

Writer: Dr Dittakarn Boriboonhirunsarn
Position: Writer